1 year post mini tummy tuck, rectus reconstruction and liposuction - What could be causing changes in sensation? (photos)

Hi Joohnny87,

Thank you for your inquiry regarding the changes in sensation you've noticed a year post mini tummy tuck, rectus reconstruction, and liposuction. The sensations you're describing are likely attributed to organizing scar tissue. In the process of a tummy tuck, an incision is made low on the abdomen, and tissue dissection reaches as far up as the sternum, essentially undermining the entire abdominal plane. Full recovery from such a procedure can span several years. This scar tissue, on occasion, can produce unsettling sensations, particularly during specific movements, and is the most common reason for your described changes. Notably, these alterations in sensation can persist for 2 to 3 years post-surgery, and if liposuction was involved, the scar tissue resolution could take even longer.

While there isn't a definitive diagnostic test to pinpoint the cause of your sensation changes, if you seek further clarification, options such as an MRI or ultrasound are available. However, their results might not provide concrete answers. Ultrasounds primarily detect fluid-filled cavities, whereas MRIs focus on identifying soft tissue anomalies. It's conceivable that a suture used during the rectus reconstruction has loosened. But considering that most plastic surgeons deploy 40-50 stitches on the rectus muscle, if a single suture fails, the remaining stitches typically hold steadfast. The stimuli for the sensations and discomfort you've encountered can be highly individual. For some, there may be no evident trigger, resulting in sporadic shocks, while others might pinpoint specific movements as aggravators.

Analyzing the photos you've shared, I doubt the sensations arise from a separation of the abdominal muscles. Yet, if concerns about muscle separation linger, an MRI could offer more clarity.

In summary, the symptoms you're encountering most likely stem from internal adhesions and the formation of scar tissue, both of which are anticipated consequences following a tummy tuck.

Wishing you the best on your recovery journey.

Sincerely,
Dr. Katzen

Hello, thanks for your photos and for the questions. Surely you are uncomfortable and even worried, you should know that the tissue takes between 1 to 3 years to heal, you should try to identify which movements and type of clothing when you put it on, cause you the most discomfort.

The ideal would be for you to go with the surgeon who performed the operation, since he knows all the details and follow-up. If you don't trust or want to change your surgeon, it is also valid. be sure to visit an expert that based on evaluation and tests will provide you with improvement.
Good luck!

I encourage you to visit with your surgeon about your concerns as she/he is most familiar with the details of your surgery and how you've been progressing through recovery. Changes in sensation such as continual numb areas can persist after a tummy tuck or liposuction. If they are still present a year after surgery they may be permanent. Sensations of occasional tightness can persist several months after surgery. This may be improved with gentle stretching exercises. Your surgeon can help you determine which are best for you.

Healing following any kind of surgery takes a minimum of one year and in terms of sensation can take up to two years.

Sensory nerves however take up to two years to completely regenerate and even then it may be incomplete. If your symptoms are tingling, minor electric shocks, or sensitivity while clothes touching the skin you are experiencing what is called paresthesias. This is a sign that the nerves are waking up and that you should have at least partial return of sensation.
Treatment of paresthesias is simple and supportive in nature. If they happen to be severe then there are medications that can help with this nerve pain. The simplest treatment is called desensitization. This involves re educating your brain about the sensory inputs you're getting. One way to desensitize the skin is to use a baby soft hair brush and gently glide the bristles over the skin several times a day. Items with different textures are then employed such as a wash cloth, rice, sand et cetera.

Medications can be used to reduce the discomfort of nerve regeneration include gabapentin and amitriptyline both of which can be sedating and are typically given before bedtime. Another medication available is called Lyrica which is more expensive.

There is a small possibility, if the pain is very localized to one spot only, that you've developed a neuroma which is essentially a ball of nerve endings that have grown but have been unable to reattach to the skin or nerve receptors and when stimulated is quite painful. This is determined merely on physical exam by the presence of what's called Tinel sign. This is elucidated by lightly tapping on the point of maximal tenderness which will elicit an electric shock type discomfort. A minor surgical procedure or injection can usually fix this.